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A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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Effectiveness of Leading Light by Reflecting the Characteristics of Marine Traffic at Gamcheon Port (감천항 선박교통 특성을 반영한 도등 효용성 분석)

  • Shin-Young Ha;Seung-gi Gug
    • Journal of Navigation and Port Research
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    • v.48 no.3
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    • pp.232-238
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    • 2024
  • This study examines the effectiveness of Gamcheon Port's leading lights in reflecting the characteristics of ship traffic entering the port. The leading light of Gamcheon Port was proposed and installed in 1996 during the basic design process of supplementing the port's route signs for the entry and exit of 4,000 TEU container ships. Since then, it has been improved to accommodate the entry of 50,000 DWT general cargo ships and to reflect the crane height of Hanjin Pier, as a result of a review study conducted by the Busan Regional Maritime Affairs and Fisheries Administration to improve the still temperature of Gamcheon Port by relocating existing outer facilities. However, an analysis of the current characteristics of maritime traffic at Gamcheon Port reveals that maritime traffic congestion is smooth and the proportion of small and medium-sized ships under 10,000 tons is higher than that of large ships, resulting in decreased efficiency of the leading lights to respond to the entry of large ships. Nevertheless, considering the increasing CAGR of the entry ratio of ships of 30,000 tons or more by 8.45%, preparations for the anticipated increase in the proportion of large ships entering the port in the future are necessary, and it is preferable to maintain the function of the leading lights rather than demolishing the entrance to Gamcheon Port. The narrow nature of the Gamcheon Port route poses a higher risk of collision when ships entering and exiting encounter each other, which can burden the navigator. Therefore, instead of maintaining the function of the leading lights, it is possible to relocate the conduction light to reduce maintenance burden and install a direction light in its place. When installing the direction light, it is worth considering using Double Sector Lights instead of the currently installed Single Sector Lights at nearby Busan Bukhang Port, as the former can improve user satisfaction by providing a clearer middle line and reducing difficulties in distinguishing between points.

Stratigraphic response to tectonic evolution of sedimentary basins in the Yellow Sea and adjacent areas (황해 및 인접 지역 퇴적분지들의 구조적 진화에 따른 층서)

  • Ryo In Chang;Kim Boo Yang;Kwak won Jun;Kim Gi Hyoun;Park Se Jin
    • The Korean Journal of Petroleum Geology
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    • v.8 no.1_2 s.9
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    • pp.1-43
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    • 2000
  • A comparison study for understanding a stratigraphic response to tectonic evolution of sedimentary basins in the Yellow Sea and adjacent areas was carried out by using an integrated stratigraphic technology. As an interim result, we propose a stratigraphic framework that allows temporal and spatial correlation of the sedimentary successions in the basins. This stratigraphic framework will use as a new stratigraphic paradigm for hydrocarbon exploration in the Yellow Sea and adjacent areas. Integrated stratigraphic analysis in conjunction with sequence-keyed biostratigraphy allows us to define nine stratigraphic units in the basins: Cambro-Ordovician, Carboniferous-Triassic, early to middle Jurassic, late Jurassic-early Cretaceous, late Cretaceous, Paleocene-Eocene, Oligocene, early Miocene, and middle Miocene-Pliocene. They are tectono-stratigraphic units that provide time-sliced information on basin-forming tectonics, sedimentation, and basin-modifying tectonics of sedimentary basins in the Yellow Sea and adjacent area. In the Paleozoic, the South Yellow Sea basin was initiated as a marginal sag basin in the northern margin of the South China Block. Siliciclastic and carbonate sediments were deposited in the basin, showing cyclic fashions due to relative sea-level fluctuations. During the Devonian, however, the basin was once uplifted and deformed due to the Caledonian Orogeny, which resulted in an unconformity between the Cambro-Ordovician and the Carboniferous-Triassic units. The second orogenic event, Indosinian Orogeny, occurred in the late Permian-late Triassic, when the North China block began to collide with the South China block. Collision of the North and South China blocks produced the Qinling-Dabie-Sulu-Imjin foldbelts and led to the uplift and deformation of the Paleozoic strata. Subsequent rapid subsidence of the foreland parallel to the foldbelts formed the Bohai and the West Korean Bay basins where infilled with the early to middle Jurassic molasse sediments. Also Piggyback basins locally developed along the thrust. The later intensive Yanshanian (first) Orogeny modified these foreland and Piggyback basins in the late Jurassic. The South Yellow Sea basin, however, was likely to be a continental interior sag basin during the early to middle Jurassic. The early to middle Jurassic unit in the South Yellow Sea basin is characterized by fluvial to lacustrine sandstone and shale with a thick basal quartz conglomerate that contains well-sorted and well-rounded gravels. Meanwhile, the Tan-Lu fault system underwent a sinistrai strike-slip wrench movement in the late Triassic and continued into the Jurassic and Cretaceous until the early Tertiary. In the late Jurassic, development of second- or third-order wrench faults along the Tan-Lu fault system probably initiated a series of small-scale strike-slip extensional basins. Continued sinistral movement of the Tan-Lu fault until the late Eocene caused a megashear in the South Yellow Sea basin, forming a large-scale pull-apart basin. However, the Bohai basin was uplifted and severely modified during this period. h pronounced Yanshanian Orogeny (second and third) was marked by the unconformity between the early Cretaceous and late Eocene in the Bohai basin. In the late Eocene, the Indian Plate began to collide with the Eurasian Plate, forming a megasuture zone. This orogenic event, namely the Himalayan Orogeny, was probably responsible for the change of motion of the Tan-Lu fault system from left-lateral to right-lateral. The right-lateral strike-slip movement of the Tan-Lu fault caused the tectonic inversion of the South Yellow Sea basin and the pull-apart opening of the Bohai basin. Thus, the Oligocene was the main period of sedimentation in the Bohai basin as well as severe tectonic modification of the South Yellow Sea basin. After the Oligocene, the Yellow Sea and Bohai basins have maintained thermal subsidence up to the present with short periods of marine transgressions extending into the land part of the present basins.

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